Comparison of three different post-pitching recovery strategies

Department: University of Delaware, Department of Kinesiology and Applied Physiology

Publisher: University of Delaware

Date Issued: 2016

Abstract: Context: Pitchers commonly attempt a variety of recovery methods after throwing to regain range of motion (ROM), strength, and velocity while reducing soreness. However, few prospective studies have been conducted to determine which common post-pitching recovery techniques provide the best acute restoration of patient function. Objective: To compare the effects of three different post-pitching recovery strategies in a collegiate baseball setting. Design: Randomized crossover design competed in a research laboratory, Athletic Training Room, and a baseball field. Participants: 13 collegiate pitchers at the Division 1 level between the ages of 18-22. Interventions: All participants underwent three recovery protocols (stretching, throwing, scapular-specific exercises) the day after they pitched in team scrimmages for three consecutive weeks. Ice was applied after each protocol. Recovery protocols were randomized, and measurements were taken at three different intervals (baseline, two days post-pitching, and four days post-pitching. Main Outcome Measures: The dependent variables of glenohumeral internal and external (ROM), infraspinatus Cross-Sectional Area (CSA), shoulder strength, fastball velocity, and self-reported preference were collected to determine recovery from impairments associated with pitching. Musculoskeletal ultrasound was used to measure the cross-sectional area of the infraspinatus. A handheld dynamometer was used to measure shoulder strength. A handheld velocity gun was used to measure the velocity of fastballs thrown, and a digital inclinometer was used to measure glenohumeral rotation. All data were compared using 3x2 repeated measures ANOVAs. Results: A significant program by time effect existed for IR ROM (F4,28 =.627, P =.022). Post-hoc testing revealed that the strength group showed a significant decrease in internal rotation two days after pitching (baseline = 40.4±10.0, day 2 = 38.3± 7.0) that was greater the loss experienced after other recovery programs. This range of motion deficit returned to a value on day 4 that was improved (47.3 ±5.6) compared to baseline and the other recovery protocols, but that value was not statistically significant. A main effect for time did occur from baseline to day 4 where athletes increased strength in extension (F2,20 = 7.998, P = .003) and adduction (F1,13 = 13.268, P = .002). No significant interactions existed for CSA or Velocity. 12/13 (92%) of players preferred the stretching routine. Conclusions: Performing scapular strengthening exercises on the first day after pitching resulted in significantly less internal rotation ROM on the second day after pitching but greater ROM by the fourth day when compared to stretching and throwing. Performing post-pitching recovery increased some strength measures on day four of each protocol compared to baseline. Based on the data collected in this study, the current recommendation is that a collegiate starting pitcher should complete scapular strengthening exercises on the day after pitching in order to gain full internal ROM by day four.